Syndrome of fulminant sepsis in splenectomized (overwhelming postsplenectomy infection - OPSI) is feared and often fatal infectious complication in patients after splenectomy. The risk of syndrome of fulminant sepsis in splenectomized in these persons persists lifelong and doesn't diminish during the time. Etiologically, encapsulated bacterias like Streptococcus pneumoniae, Haemophilus influenzae group b and Neisseria meningitidis are involved. As the mortality of syndrome of fulminant sepsis in splenectomized is very high, it is indispensable to educate and vaccinate persons in risk. The authors present case reports of three splenectomized patients who were hospitalized for invasive pneumococcal infection in the University Hospital Brno, Czech Republic, in 2011.
- MeSH
- dospělí MeSH
- imunokompromitovaný pacient * MeSH
- lidé MeSH
- mladý dospělý MeSH
- pneumokokové infekce etiologie imunologie MeSH
- sepse etiologie MeSH
- splenektomie škodlivé účinky MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- Publikační typ
- anglický abstrakt MeSH
- časopisecké články MeSH
- kazuistiky MeSH
Patients with a suspected or confirmed liver disease are frequent attendees at internal medicine outpatient clinics. Metabolic and toxic liver lesions are presently much more prevalent than infectious liver diseases. Liver steatosis and drug-induced liver impairment are the most frequent. The main task for internal medicine specialists in primary care with respect to chronic viral hepatitis B and C is to keep these diseases in mind and when an increased alaninaminotranspherase activity is detected, to perform blood tests for the presence of HBsAg as well as anti-HCV antibodies. Epidemiologically high-risk patients should always be tested for the presence of HBsAg and anti-HCV (even with normal ALT activity).
- MeSH
- ambulantní zařízení * MeSH
- lidé MeSH
- nemoci jater diagnóza epidemiologie terapie MeSH
- primární zdravotní péče * MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- anglický abstrakt MeSH
- časopisecké články MeSH
- Geografické názvy
- Česká republika epidemiologie MeSH
Chronic hepatitis B is one of the world's most common infectious diseases. In the Czech Republic it has a prevalence of 0.56%. Antiviral therapy for chronic hepatitis B demonstrably increases quality of life and where indication criteria are met and standard therapeutic procedures are followed, it is clearly cheaper than treatment for the complications of advanced cirrhosis of the liver or hepatocellular carcinoma. At the time of issuing of this recommendation, 4 medicines were classified for the treatment of chronic hepatitis B in the Czech Republic--pegylated interferon (IFN) alpha-2a, conventional IFN alpha, lamivudine (LAM) and adefovir dipivoxil (ADV). In a number of other developed states, entecavir (ETV) and telbivudine (LdT) have also been approved for treatment. The most effective treatment available at present is pegylated IFN alpha-2a, which should be the medication of first choice for initial treatment of hepatitis B, HBeAg positive and negative forms, provided that there are no contraindications for IFN alpha treatment. Conventional (standard, classical) IFN alpha can also be used, though clinical studies have shown it to be less effective than pegylated IFN alpha-2a. The main advantage of interferon compared to other commercially available medications is its relatively shorter and more clearly defined treatment period, the high probability of permanent suppression of virus replication and seroconversion of HBeAg/anti-HBe (in HBeAg positive forms of the illness) and the non-creation of mutant strains of HBV resistant to IFN in the course of treatment. If there are contraindications for IFN alpha (pegylated or conventional) or it is ineffective or poorly tolerated, ADV, ETV, LAM or LdT can be used. LAM and LdT treatments are often accompanied by the appearance of mutant strains of HBV, that are resistant to lamivudine or LdT and therefore they are not preferred.
- MeSH
- chronická hepatitida B diagnóza farmakoterapie MeSH
- lidé MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- anglický abstrakt MeSH
- časopisecké články MeSH
- směrnice pro lékařskou praxi MeSH
A 30 years old man originating from Ukraine was infected by the human immunodeficiency virus (HIV) and virus of hepatitis C (HCV) due to injection administration of drugs of abuse in his own country before coming to Czech Republic. He was infected by genotype 3 of HCV and the infection became chronic. Under the influence of a three-combination anti-retrovirus therapy his conditions related to HIV infection became stable and it proved to be possible to apply a combined treatment by alpha-interferon and ribavirin at commonly used doses for the period of 12 months. In the course of therapy the HCV nucleic acid (HCV RNA) disappeared from serum and serum activity of alanine aminotransferase (ALT) became normal. However, two months after the therapy ended a relapse of the disease occurred--HCV RNA reappeared in serum and ALT activity increased. The therapy was well tolerated. A rapid decrease of hemoglobin level during the first four weeks of therapy was stopped by reduction of ribavirin dose.
- MeSH
- chronická hepatitida C komplikace farmakoterapie MeSH
- HIV infekce komplikace MeSH
- lidé středního věku MeSH
- lidé MeSH
- oportunní infekce doprovázející AIDS farmakoterapie MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- anglický abstrakt MeSH
- časopisecké články MeSH
- kazuistiky MeSH
The SEN virus (SENV) is a small nonenveloped single-stranded DNA virus which is probably a circovirus. By phylogenetic analysis it is possible to differentiate genotypes SENV A-H. The pathway of transmission of infection is not known so far but the infection by this virus is frequent in recipients of blood transfusions and liver grafts and in intravenous drug addicts. This suggests possible parenteral transmission of infection. Other routes of transmission of the infection are also possible as the virus can be detected also in a significant proportion of young subjects without the risk of parenteral infection in the case-history. Whether SENV causes hepatitis has not been proved unequivocally so far. The prevalence of this infection does not differ significantly in patients with different liver diseases, acute or chronic viral or non-viral. SENV infection very probably does not influence the course of chronic hepatitis C.
- MeSH
- DNA viry klasifikace izolace a purifikace MeSH
- infekce DNA virem přenos MeSH
- lidé MeSH
- virová hepatitida u lidí přenos virologie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- anglický abstrakt MeSH
- časopisecké články MeSH
- přehledy MeSH
